A Probabilistic and Individualized Approach for Predicting Treatment Gains: An Extension and Application to Anxiety Disordered Youth

The objective of this study was to extend the probability of treatment benefit method by adding treatment condition as a stratifying variable, and illustrate this extension of the methodology using the Child and Adolescent Anxiety Multimodal Study data. The probability of treatment benefit method produces a simple and practical way to predict individualized treatment benefit based on pretreatment patient characteristics. Two pretreatment patient characteristics were selected in the production of the probability of treatment benefit charts: baseline anxiety severity, measured by the Pediatric Anxiety Rating Scale, and treatment condition (cognitive-behavioral therapy, sertraline, their combination, and placebo). We produced two charts as exemplars which provide individualized and probabilistic information for treatment response and outcome to treatments for child anxiety. We discuss the implications of the use of the probability of treatment benefit method, particularly with regard to patient-centered outcomes and individualized decision-making in psychology and psychiatry.     

Why Jesus?

Jesus plays potentially a uniquely important role in relation to the world's greatest needs. To respond to the global crisis, we need historical consciousness. The source of historical consciousness is the prophetic tradition. Through Jesus the prophetic tradition became widely available and important. However, this consciousness has been responsible for great evil as well as great good, often bound up with we/they thinking and the use of violence. Jesus’ teaching of love of the enemy in principle overcomes this tendency and points to way forward.     

The View from Way Below: Inter‐Species Encounter,Membranes, and the Reality of Christ

Viewing modern life from the perspective and world of those whose lives are treated as expendable commodities in our current economic systems—humans and creatures of every other species—creates, Bonhoeffer asserts, the most reliable hermeneutical standpoint for seeing and living in reality. This essay attempts to fashion in broad strokes a Christian theology of creaturely re‐engagement: learning to live again “way below,” in literal and metaphoric touch with reality. I assert that Bonhoeffer's theology of I/Thou encounter as the means of humans’ ethical formation has the potential to ground a broader theology of inter‐species encounter as well.     

ENTHEOGENS IN A RELIGIOUS CONTEXT: THE CASE OF THE SANTO DAIME RELIGIOUS TRADITION

This essay first draws upon the work of William James and others to propose a nonphysicalistic understanding of the relationship between the brain and consciousness in order to articulate a philosophical perspective that can understand entheogenic visionary/mystical experiences as something other than hallucinations. It then focuses on the Santo Daime tradition, a religious movement that began in Brazil in the early part of the twentieth century, to provide an example of the personal and social ramifications of taking an entheogen (ayahuasca) within a disciplined religious context. The essay claims that the Santo Daime is one example of a contemporary mystery school; gives a brief history of the development of this religion; discusses the key theological assumptions of this movement; investigates the important role played by visionary/mystical experiences within this religion; underscores the centrality of healing and spiritual transformation for members of this tradition; and ends with an examination of the crucial significance of spiritual discipline within this entheogenically based religion.     

Gut interpretations: how difficulties in emotion regulation may help explain the relation of visceral sensitivity with depression and anxiety among young adults with gastrointestinal symptoms

It is widely recognized that abdominal pain and discomfort are common problems in the United States and are often associated with negative quality of life. The prevalence of anxiety/depression elevations and disorders among persons with gastrointestinal disturbances (GI) is estimated to be at least two to three times the rate in the general population. Visceral sensitivity reflects anxiety about GI sensations and its accompanying contexts and often leads to worsening of sensations (e.g. bloating, upset stomach, diarrhea). Among individuals with GI symptoms, visceral sensitivity may be associated with interpreting common sensations as catastrophic which may be related to greater difficulties with emotion dysregulation (e.g. severe anxiety and depression). The current study evaluated the indirect association of visceral sensitivity via emotion dysregulation in relation to depression, anxious arousal, and social anxiety symptoms among 344 young adults with a current history of GI symptoms and problems. Results indicated an indirect effect of visceral sensitivity via emotion dysregulation. These findings provide novel empirical support for the association of visceral sensitivity with emotional distress symptoms among young adults with GI symptoms. Based on the results, targeting emotion dysregulation may be a promising health promotion tactic among young adults with GI symptoms and disorders.     

Women’s breast-feeding meanings in the context of mother-to-child transmission of HIV

This study explored infant feeding practice meanings of HIV-positive mothers. Informants were eight black South African mothers (age range 18–29 years) enrolled in a mother-to-child transmission (MTCT) prevention programme. In-depth interviews on factors that influence exclusive breast-feeding were conducted with the mothers. Thematic analysis of the data yielded meanings around practices of knowledge contestation with health care providers and family, work demands, and personal preferences. Moreover, successful breast-feeding by mothers with HIV status may depend on addressing contradictory messages by health workers on infant feeding and community and family pressure to mix-feed the infant children.     

In Defense of “Denial”: Difficulty Knowing When Beliefs Are Unrealistic and Whether Unrealistic Beliefs Are Bad

Bioethicists often draw sharp distinctions between hope and states like denial, self-deception, and unrealistic optimism. But what, exactly, is the difference between hope and its more suspect cousins? One common way of drawing the distinction focuses on accuracy of belief about the desired outcome: Hope, though perhaps sometimes misplaced, does not involve inaccuracy in the way that these other states do. Because inaccurate beliefs are thought to compromise informed decision making, bioethicists have considered these states to be ones where intervention is needed either to correct the person’s mental state or to persuade the person to behave differently, or even to deny the person certain options (e.g., another round of chemotherapy). In this article, we argue that it is difficult to determine whether a patient is really in denial, self-deceived, or unrealistically optimistic. Moreover, even when we are confident that beliefs are unrealistic, they are not always as harmful as critics contend. As a result, we need to be more permissive in our approach to patients who we believe are unrealistically optimistic, in denial, or self-deceived—that is, unless patients significantly misunderstand their situation and thus make decisions that are clearly bad for them (especially in light of their own values and goals), we should not intervene by trying to change their mental states or persuade them to behave differently, or by paternalistically denying them certain options (e.g., a risky procedure).     

Differentiating crisis incidents: A replication study using the action systems model

Crisis incidents are volatile situations that can pose significant risk to those involved and to law enforcement. The idiosyncratic conditions that lead to such incidents, as well as their volatility, often militate against consistent explanatory models. However, the application of overarching paradigms, such as the action systems model, has shown some promise in imposing order in the domain. Recent research has successfully differentiated crisis incidents into the four distinct modes of the action systems model: conservative, adaptive, integrative, and expressive. The purpose of this paper is to attempt to replicate this recent study using 242 cases from the United States, Ireland, Canada, and Sweden. Data analysis involves smallest space analyses and constrained multidimensional scaling. Although the results supported the underlying structure of original proposed behavioural model, there are a few deviances. These differences along with the potential influence of cultural variations, offence variable selection, the type of incident, and the sample under scrutiny are discussed. It is evident that there remain several challenges, and further research is required, prior to developing a unified framework.